Psychopharmacology
October 4, 2018
Baland Jalal
42 citations
Sleep paralysis involves involuntary immobility at sleep onset or offset, often with 'ghost-like' hallucinations and intense fear. This account proposes that serotonin 2A receptor (5-HT2AR) activation underlies these hallucinatory experiences, drawing parallels to serotonergic hallucinations induced by drugs like LSD and psilocybin, which are dream-like and retain insight, unlike dopaminergic hallucinations. The mechanism suggests 5-HT2AR activity generates visual hallucinations, mystical states, out-of-body experiences, and fear. The role of 5-HT2C receptors in anxiety and the orbitofrontal cortex in visual pathways is speculated. Pimavanserin, a selective 5-HT2AR inverse agonist, is proposed as a first drug to target these symptoms, implicating gene HTR2A on chromosome 13q.
Frontiers in Human Neuroscience
February 27, 2017
Baland Jalal, Vilayanur S. Ramachandran
38 citations
This opinion article argues that the concept of brain health should be expanded beyond the absence of disease to include optimal cognitive and emotional functioning across the lifespan. The authors propose a framework that integrates neuroscience, psychology, and public health to promote resilience and well-being. They suggest that lifestyle factors, such as diet, exercise, and social engagement, can enhance brain health and reduce the risk of neurodegenerative conditions. The piece calls for a shift in research and clinical practice toward proactive, preventive approaches that empower individuals to maintain brain health throughout life.
Frontiers in Neurology
January 1, 2020
Baland Jalal, Ludovico Moruzzi, Andrea Zangrandi et al.
13 citations
A small pilot study tested Meditation-Relaxation (MR) therapy for sleep paralysis (SP) in ten patients with narcolepsy. Over eight weeks, the six patients receiving MR therapy showed a 50% reduction in days with SP and a 54% reduction in total SP episodes in the last month, with large within-group effect sizes. The four patients in the control group (deep breathing) did not show similar improvement. These preliminary findings provide the first proof-of-concept evidence that MR therapy may reduce frequent SP, and the authors cautiously suggest the approach might generalize to people with isolated SP.
BMC Psychiatry
June 7, 2022
Paulina Wróbel-knybel, Michał Flis, Joanna Róg et al.
9 citations
Sleep paralysis affects 33.14% of Polish students, highlighting its significant prevalence in this population. Among the 2,553 analyzed participants, factors like having three or more health issues (odds ratio of 2.3) and any mental disorder (1.77) increased the likelihood of experiencing sleep paralysis. High anxiety levels (1.20), smoking (1.48), and alcohol consumption (1.52) also contributed to this risk. These findings suggest that mental health status, lifestyle choices, and physical health are critical in understanding sleep disorders like sleep paralysis among students.
Medical Hypotheses
March 1, 2021
Baland Jalal
Sleep paralysis is a condition in which a person, while paralyzed, may hallucinate terrifying ghosts—often faceless shadows, but also full figures like cat-like creatures or witches. This paper proposes a neuroscientific account explaining why these hallucinations occur and why they typically appear as faceless shadows. The account focuses on the distinct computational styles of the right and left hemispheres, suggesting that ghost hallucinations and out-of-body experiences during sleep paralysis are primarily mediated by activity in key right-hemisphere regions. The visual system's economizing nature, including surface interpolation and shortcuts, is invoked to explain faceless humanoid-shadows and sensed presence. The hypothalamus and anterior cingulate may also be involved in related dissociative states. The author notes that empirical research is needed to validate this hypothesis.
International Journal of Environmental Research and Public Health
June 25, 2022
Paulina Wróbel-knybel, Michał Flis, Joanna Róg et al.
Sleep paralysis (SP) is a temporary inability to move while conscious, occurring when falling asleep or waking up. Among 844 professionals at high risk—nurses and midwives, police officers, teachers, and a mixed group—prevalence ranged from 15.5% in police officers to 39.4% in the mixed group. Symptoms of PTSD and anxiety were linked to SP in nurses and the mixed group. Other factors associated with SP frequency and severity included age, body mass index, smoking, alcohol use, sleep duration, and perceived stress. The findings indicate that psychological and lifestyle factors together contribute to SP, suggesting a complex cause and the need for targeted prevention and treatment.
Transcultural Psychiatry
June 1, 2021
Baland Jalal, H Sevde Eskici, Ceren Acarturk et al.
In a study of 59 Turkish college students who had experienced sleep paralysis, 88% knew it as the "Karabasan," a spirit-like creature from Turkish folklore. Seventeen percent believed their sleep paralysis might have been caused by this supernatural entity. To prevent future episodes, 37% used religious or supernatural methods such as supplicating to God (dua), reciting the Quran, or wearing a talisman (musqa) inscribed with Quranic verses. The findings illustrate how cultural beliefs shape the interpretation of sleep paralysis in Turkey, with the Karabasan providing a culturally specific supernatural explanation for the experience.
Transcultural Psychiatry
June 1, 2021
Baland Jalal, Andrea Romanelli, Devon E Hinton
In Italy's Abruzzo region, where supernatural beliefs about sleep paralysis (SP) are common, 78% of 67 participants who had experienced SP at least once reported hallucinations during episodes. Lifetime rates of SP, duration of immobility, and fear were elevated compared to cultures without such traditions, with 42% fearing they could die from the experience. Cultural beliefs, such as the Pandafeche creature, may shape the phenomenology of sleep paralysis.
International Journal of Environmental Research and Public Health
May 18, 2020
Paulina Wróbel-knybel, Hanna Karakuła-juchnowicz, Michał Flis et al.
Sleep paralysis affects about 7.6% of the general population, but among Polish university students in Lublin the rate is 32%, higher than the 28.3% average for other student populations. Somatic symptoms dominate: 94% of those reporting sleep paralysis experienced physical sensations, most commonly rapid heartbeat (76%); 93% reported fear, especially fear of death (46%); and 66% had hallucinations, mostly visual (37%). More frequent episodes were linked to shorter sleep and sleeping on the back. Severity of physical symptoms correlated with lifestyle factors and anxiety. A substantial number of students experience recurrent sleep paralysis accompanied by fear and physical distress.
Frontiers in Psychology
May 16, 2017
Baland Jalal
This response addresses a commentary on the author's earlier work proposing a treatment for sleep paralysis. The author contends that the commentary misrepresents the original study's claims and methodology. The author reiterates that focused-attention meditation combined with muscle relaxation (MR therapy) is a direct treatment intervention for sleep paralysis, designed to be used during episodes. The author argues that the commentary's criticisms are based on misunderstandings and that the proposed therapy remains a viable and direct approach for managing sleep paralysis symptoms.
The Journal of Nervous and Mental Disease
November 1, 2015
Baland Jalal, Devon E Hinton
Among 100 Egyptian college students in Cairo, 43% reported at least one lifetime episode of sleep paralysis (SP), and 24% of those had four or more episodes in the previous year. Women accounted for 86% of SP experiences, men for 14%. Compared to those without SP, participants who experienced it reported higher symptoms of PTSD, trait anxiety, and pathological worry. Hallucinations during SP were strongly linked to PTSD and trait anxiety symptoms, even after controlling for negative affect.
Medical Hypotheses
December 1, 2014
Baland Jalal, Vilayanur S. Ramachandran
Sleep paralysis involves temporary motor paralysis while awake, often accompanied by hallucinations of a menacing shadowy intruder in the bedroom. This paper proposes that such hallucinations arise from a functional disturbance in the right parietal cortex, specifically the temporoparietal junction, which processes body and self. The perceived intruder may be a hallucinated projection of the brain's internal body image (homunculus) from the right superior parietal lobule. The authors suggest testing this by studying individuals with conditions like apotemnophilia or anorexia nervosa, who may have irregularities in their internal body image, to see if their hallucinations mirror those irregularities. If confirmed, this neurological explanation could offer relief to those who experience sleep paralysis and counter supernatural cultural interpretations.